Last week, the Japanese government released an interim report about the handling of events at the Fukushima Daiichi reactors in March.

This outlined a series of failures before the meltdowns at the plant, and by TEPCO and the government afterwards. However it did not address the significant ongoing public health risks.

The interim report has a depressing familiarity in the many problems outlined. Poor planning, poor regulation and poor enforcement of regulations led to reactors unprepared for the March 11 tsunami. A cosy relationship between the regulators and the power companies paved the way. There is a longstanding pattern of employees moving back and forth between the nuclear power companies and the nuclear regulator. The risk of tsunami was recognised in 1992, but no regulations ensued, and power companies were left free to choose what measures they would take.

In 2008, when the risk of tsunami was again considered, an expected tsunami exceeding 15 meters was projected for the Fukushima No. 1 nuclear power plant. But Tokyo Electric Power Company (TEPCO) officials dismissed the figure as hypothetical. A second study in 2008 using different modeling suggested wave heights of nine metres, but again TEPCO officials disregarded the findings. Inspection guidelines for anti-quake design took five years and were completed in September 2009, but again these were never implemented.

Then, at the plant after the tsunami, poor planning, poor training, human error and ignorance compounded the situation. At the No 1 reactor workers mistakenly believed the isolated condenser was working normally. At the No 3 reactor workers stopped high pressure coolant injection because of concerns about leakage, yet failed to arrange for water to be pumped in as an alternative cooling method. Both these errors (and others) contributed to the core meltdowns.

Meanwhile, in Tokyo prime minister Naoto Kan and senior officials assembled in his fifth floor office as the central decision making body. In the basement below them, a taskforce of senior public servants was established at the crisis management centre under the special measures law relating to nuclear accidents. Both groups initially thought they were in charge.

Communication between the two was so poor that the results of a forecast made by the System for Prediction of Environmental Emergency Dose Information (SPEEDI), which is designed for use in deciding evacuation orders, never reached the fifth floor.

In the last few months, in TEPCO's haste to declare the plants in a state of "cold shut down", it has been reported that poor quality materials and techniques have been used at the plant. According to Tomohiko Suzuki, a journalist who worked undercover at the Fukushima reactors from June to August this year, sub-standard pipes prone to freezing damage and leakage were being hastily laid without the usual techniques for assuring durable connections. This increases the risk of further radiation leakage in the near future. Also there remains 120,000 tonnes of highly radioactive water underneath the plant, and there has been significant and ongoing leakage into the ocean.

There have been many failures in the handling of this situation. But perhaps the greatest relate to the government's duty of care to protect Japanese citizens. The government failed to act on information about radioactive plumes. In doing so it exposed many communities to harmful radiation, and many evacuated into even higher radioactive areas.

In addition, the government has declared the "safe" allowable limits for radiation exposure can be changed from the internationally accepted levels of 1 mSv to 20 mSv a year. Women and children are particularly sensitive to radiation exposure. Subjecting children to 20mSv a year for five years will result in about 1 in 30 developing cancer. After Chernobyl anyone likely to be exposed to more than 5 mSv a year was evacuated, and those in areas of 1-5 mSv were offered relocation and bans were placed on eating locally produced food.

Finally, there is an ongoing culture of poor monitoring, poor information release and cover up. It continues to significantly under report radiation levels, claiming total radiation releases at approximately half the level of observed releases detected by world wide Nuclear Test Ban Treaty monitoring sites. Current radioactivity levels are measured at 1 metre off the ground, not at ground level where children play and where radioactivity levels are significantly higher.

This is no longer an emergency situation, and the health risks do not disappear by legislating a convenient figure for radiation exposure.

From a public health perspective the Japanese government continues to fail to protect its people, particularly its children. To quote Tilman Ruff, Associate Professor at the Nossal Institute for Global Health, "At this point, the single most important public health measure to minimi[s]e the health harm over the long term is much wider evacuation."